Diaz-Mitoma F, Benningen G, Slutchuk M, Ronald A R, Brunham R C
Sex Transm Dis. 1987 Jan-Mar;14(1):33-6. doi: 10.1097/00007435-198701000-00007.
Twenty-eight patients with recent onset of nonvesicular ulcerative genital lesions were studied prospectively to define the microbial etiology. Causative agents identified included herpes simplex virus (HSV), Chlamydia trachomatis, Haemophilus ducreyi, and Treponema pallidum. Three women and 25 men (seven of whom were homosexual) were studied. Ten patients did not have an etiology identified. Nine patients had syphilis, six had genital herpes, one had chancroid, one had granuloma inguinale, and one had a human bite injury. Six of seven homosexual men had syphilis, as compared with one of eight heterosexual men (P less than .002). Among heterosexual men, five had atypical HSV infections, three with extensive balanoposthitis and two with chancroidal ulcers. Of the clinical characteristics examined, induration of the ulcer base and tenderness on palpation were predictive of etiology, whereas numbers of ulcers and regional lymphadenopathy were not. H. ducreyi was not a common cause of genital ulcers in Winnipeg, and it was not found as a commensal or superinfecting organism in ulcers caused by other agents.
对28例近期出现非水疱性溃疡性生殖器病变的患者进行了前瞻性研究，以确定微生物病因。鉴定出的病原体包括单纯疱疹病毒（HSV）、沙眼衣原体、杜克雷嗜血杆菌和梅毒螺旋体。研究对象包括3名女性和25名男性（其中7名是同性恋者）。10例患者未明确病因。9例患有梅毒，6例患有生殖器疱疹，1例患有软下疳，1例患有腹股沟肉芽肿，1例有人咬伤。7名同性恋男性中有6例患有梅毒，而异性恋男性8例中有1例患有梅毒（P<0.002）。在异性恋男性中，5例有非典型HSV感染，3例有广泛的阴茎头炎，2例有软下疳溃疡。在所检查的临床特征中，溃疡底部硬结和触诊压痛可预测病因，而溃疡数量和局部淋巴结病则不能。杜克雷嗜血杆菌不是温尼伯生殖器溃疡的常见病因，在其他病原体引起的溃疡中未发现其作为共生菌或重叠感染菌。
